Case study Q&A: Defining the response of lymphoma treatment before high-dose chemotherapy

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Dr Stefano Luminari addresses several key points relating to the case presentation of a 23-year-old female presenting with classical Hodgkin lymphoma with nodular sclerosis, stage lVA. Dr Luminari presented this case study in behalf of www.lymphomahub.com.

We performed an FDG-PET after cycles 2 and 4 of the IGEV induction regimen, both showing the achievement of a complete response. Recent data have suggested a strong predictive value for FDG-PET before HDCT: a positive FDG-PET prior to the transplant program may indicate a poorer outcome for patients.1 Therefore, it has become even more important to reach a complete response during the induction phase of the salvage treatment. In cases of residual sites of disease of poor response before HDCT treatment, options are represented by the use of an alternate chemotherapy program until a better response is achieved. Recently, novel promising therapies have been developed. Among them brentuximab vedotin (BV) is currently registered as monotherapy for the treatment of relapsed/refractory HL patients after HDCT or who are not candidates for HDCT. There is a strong rationale to investigate the use of BV to improve the anti-lymphoma activity of salvage therapies.

References
1. Gallamini A, et al. Early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin’s lymphoma: a report from a joint Italian-Danish study. J Clin Oncol 2007;25:3746–52.

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